Provider Demographics
NPI:1952857641
Name:WILKINSON, EMILY S (PA-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:S
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:PA
Mailing Address - Zip Code:16428-1926
Mailing Address - Country:US
Mailing Address - Phone:814-877-7711
Mailing Address - Fax:814-877-7715
Practice Address - Street 1:2060 N PEARL ST
Practice Address - Street 2:
Practice Address - City:NORTH EAST
Practice Address - State:PA
Practice Address - Zip Code:16428-1926
Practice Address - Country:US
Practice Address - Phone:814-877-7711
Practice Address - Fax:814-877-7715
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058574363A00000X
PAOA003920363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant